More to the story on Nova Peris's claim about the NT's banned drinker register

Emergency departments in the Northern Territory are facing "extraordinary" increases in alcohol-related admissions, according to the Labor Party's Senator Nova Peris.

She claims the increases occurred after the banned drinker register, a Labor measure to stop problem drinkers from buying alcohol, was abandoned by the Country Liberal Party Government in August 2012.

"Alcohol-related emergency department admissions in Northern Territory hospitals increased by 80 per cent in 14 months since it was scrapped," Senator Peris said. She said that as predicted by police, lawyers and doctors, domestic violence rates and alcohol violence soared after the register was scrapped.

However, the Northern Territory Minister for Alcohol Rehabilitation, Robyn Lambley, says 10 years of data shows the register had no long-term impact on alcohol-related admissions to Territory emergency departments.

She says the scrapped banned drinker register was "useless in the fight against alcohol abuse".

The claim: Nova Peris says alcohol-related emergency department admissions in Northern Territory hospitals increased by 80 per cent in the 14 months after the banned drinker register was scrapped.

The verdict: Alcohol-related emergency admissions to NT hospitals did increase by 80 per cent after the register was scrapped. However, they did not decrease while the register was in place and the upward spike began before it was removed.

The banned drinker register

The register was rolled out by the NT's former Labor government from July 2011. It was an electronic system where all customers were asked to present photo identification before buying alcohol. Those on the register were banned from purchasing.

Problem drinkers were defined as people who committed alcohol-related crime or violence, those taken into custody three times in three months, or people who committed high range drink-driving or repeat drink-driving offences.

The register was devised to provide a direct health intervention for problem drinkers without criminalising alcoholism.

When the Country Liberal Party took power 14 months later the register was abandoned, and the 2,500 people on the register, many of whom lived in Central Australia, were free to buy alcohol again.

The decision to abolish the register was condemned not just by the Northern Territory Opposition, but by federal leaders from both sides of politics.

In February 2013 former prime minister Julia Gillard, in her "Closing the gap" speech, said she was concerned about the rise in admissions to the emergency department at Alice Springs Hospital due to alcohol-related accidents and abuse. She called on the NT Government to reinstate the register immediately.

Then opposition leader Tony Abbott told parliament he shared Ms Gillard's concern about the register, but stopped short of calling for its reinstatement.

Emergency department presentations

Experts say alcohol-related presentations to hospital, particularly emergency departments, are a good way of measuring the register's efficacy.

The Northern Territory Department of Health recently released data on alcohol-related emergency presentations and hospital admissions in the Northern Territory's five hospitals since 2005. Senator Peris's office told Fact Check this was the basis for her claim.

The department only released data for "alcohol wholly attributable emergency department presentations". It did not release data for presentations partly attributable to alcohol. The department told Fact Check the same coding for classifying health conditions was applied to all the data from 2005.

Long-term trend

ABC Fact Check charted the data to show alcohol-related presentations to emergency departments from July 2005 to October 2013.

The raw data provided by the health department shows there has been a long-term increasing rate of alcohol-related emergency admissions since July 2005, including during the period the register was in place.

Dr Michael Livingston from the National Drug & Alcohol Research Centre says: "There is no obvious reduction in admissions following the introduction of the banned drinker register, but something clearly shifted when it was removed, particularly in Alice Springs".

Dr Livingston says from this data alone it is not possible to say for sure what caused that shift.

He suggests looking at trends of non-alcohol-related emergency admissions over the same period would indicate whether the trends are specific to alcohol or whether they are driven by broader hospital system factors.

The health department did not provide such numbers to Fact Check, but in charts produced by the department, non-alcohol-related emergency admissions at the Alice Springs hospital do not appear to mirror the upward spike seen in alcohol-related admissions.

Jason Ferris from the Institute of Social Science Research at the University of Queensland, who specialises in biostatistics research and has an interest in alcohol policy, modelled the data for Fact Check.

He says there is one trend line from July 2005 to May 2012 which shows alcohol-related admissions "significantly increasing". He says the trend then dramatically turns upwards between May 2012 and April 2013. This means the change in trend began before the banned drinker register was abolished in August 2012.

Mr Ferris says the trend during this second period is "significantly greater than the previous trend".

He says the introduction of the register "doesn't appear to have had an observable early effect on the admission data". While it was in place, the trend turned significantly upwards, he says.

"So the removal of the ban could not be solely responsible for the upturn in presentations as these had already begun. I would believe something else was going on that triggered these increased presentations (or reporting)."

80 per cent increase

The data shows that during the 14 months the register was in place there were 3,426 alcohol-related emergency presentations, and over the next 14 months, to October 2013, there were 6,183 presentations.

This represents an 80 per cent increase in the 14 months after the register was scrapped. The population growth in the Northern Territory at the time was below the national average, at about 1.5 per cent per year.

Fact Check converted the data to percentage changes. The Royal Darwin Hospital is up 29 per cent, Katherine Hospital up 54 per cent, Gove Hospital up 55 per cent, Tennant Creek Hospital up 107 per cent, and the Alice Springs Hospital up 86 per cent.

The department's figures show Alice Springs has the highest numbers of alcohol-related emergency presentations, even though the city has around 27,000 permanent residents compared to Darwin's 130,000.

More than 90 per cent of the people being admitted to the Alice Springs emergency department for alcohol-related problems are Indigenous.

In an analysis released with the data, the department said: "Alcohol-related emergency department presentations show a slight trend increase since July 2011. The rate of this increase is more marked for Alice Springs Hospital than the other hospitals. Alcohol-related emergency department presentations to Darwin and Gove hospitals appear stable."

Current policy

Dr John Boffa, who works in public health in Alice Springs, says the register was working, but it was not in place long enough to see the effects.

He says that directly after the register was abolished, alcohol-related presentations to emergency departments "dramatically" increased.

He says hospital staff were overwhelmed with the numbers of people presenting to emergency and the Government was forced to implement a new strategy to kerb the spike. Police presence was increased at alcohol outlets.

Earlier this month, the Chief Minister for the NT, Adam Giles told 7.30: "We're seeing a reduction in wholesale consumption of alcohol and what we put that down to is more targeted or better targeted policing operations on the street in the Northern Territory since we've taken office."

Ms Lambley says: "The higher statistics recorded in Alice Springs reflect in part the increased capacity of the $23 million expansion of the Alice Springs emergency department opened last June."

However the dramatic change in trend occurred a year before the renovation was complete.

The verdict

Senator Peris is correct that alcohol-related emergency admissions in Northern Territory hospitals have increased by 80 per cent since the banned drinker register was scrapped.

However attributing this significant change to the banned drinker register does not present the full picture.

Firstly, the register did not stop the long-term increasing trend in alcohol-related emergency presentations.

Also, the serious upward spike in alcohol-related emergency presentations began in May 2012 when the register was still in place.

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